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1740729011
SANDRA DENISE MAHAN
MODESTO, CA
NPI
1740729011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-02-19
Last Update Date
2017-02-19
Business Address
-- SANDRA DENISE MAHAN
1235 MCHENRY AVE
MODESTO, CA 95350-5370
Phone number: 209-527-4597
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Mailing Address
-- SANDRA DENISE MAHAN
1235 MCHENRY AVE
MODESTO, CA 95350-5370
Phone number: 209-527-4597
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